As patients spend less time in inpatient acute rehabilitation, it is increasingly critical to focus on the essentials. Patients must participate in their prescribed therapeutic plans to improve their outcomes. Hypotension, which is common among SCI patients, can limit optimal participation in rehabilitation units, especially among people with higher level lesions. Our goal with this study is to compare anti-hypotension treatment initiated based on blood pressure threshold regardless of symptoms, to usual care of symptomatic hypotension during acute rehabilitation following SCI. We will use a two-group randomized design. We will randomly assign participants to either the blood pressure threshold treatment group or the usual care group. The usual care group will receive blood pressure management according to the current practice on the SCI Rehabilitation Unit. Those in the blood pressure threshold treatment group will receive blood pressure management, regardless of symptoms, to maintain systolic blood pressure between 111 mmHg and 135 mmHg for males and 101mmHg to 135 mmHg for females for the duration of their inpatient time. We will look at differences in therapy time spent actively involved; time spent out of blood pressure normotensive range; symptoms of hypotension or hypertension, and cerebral blood flow.